In this online CME self-learning program:
Fluid management for the critically ill is very significant in critical care medicine. Most people use traditional methods to assess the fluid status of an individual based on their clinical and hemodynamic data, and these have proven very unreliable over the years. Hemodynamic monitoring by itself does not improve outcomes; instead, related treatment requires a protocol based on physiology. Physiologic Optimization Program helps to measure the cardiac performance to determine their responsiveness to fluid. This will help to maintain organ perfusion and function. Ultimately if there is no perfusion benefit, volume is possibly or likely harmful. An individual Starling curve can be plotted to determine the optimal stroke volume for a given stroke volume variation. This will help to determine the need for fluid resuscitation or de-resuscitation based on the individuals physiologic parameters. As part of the physiologic optimization program, an algorithm has been developed using stroke volume variation as a predictor of volume responsiveness and stroke volume as a cardiac performance measure together to optimize hemodynamics under a variety of conditions.
The literature suggests that there is a gap between the actual and optimal treatment of patients in critical care with regards to fluid status and fluid need. Traditionally, practitioners believe a little volume is good but more is better and they can swell patients to get well. At the same time, emerging data indicate the healthcare professional retains a unique position in the effort to improve adherence to therapy and mortality by using physiologic optimization to assess the fluid status and fluid management.
Agenda:
- Establishing the need for physiologic optimization in fluid resuscitation
- Stroke volume variation and the Frank-Starling curve
- Treatment algorithm: following each arm to its natural end
- Patient case(s)
- Predictors of in-hospital mortality
- Summary of the evidence
This program has been designed for a multidisciplinary physician and nurse audience including: ICU / Anesthesia / Peri-op / Intensivists / Trauma / Critical Care
This program is supported by Educational Grants from Edwards Lifesciences
Release Date: February 15, 2012 -- Expiration Date: February 15, 2014
Faculty: William T. McGee, M.D., M.H.A.
By the end of the session the participant will be able to:
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As a provider of continuing medical education, it is the policy of ScientiaCME to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. In accordance with this policy, faculty and educational planners must disclose any significant relationships with commercial interests whose products or devices may be mentioned in faculty presentations, and any relationships with the commercial supporter of the activity. The intent of this disclosure is to provide the intended audience with information on which they can make their own judgments. Additionally, in the event a conflict of interest (COI) does exist, it is the policy of ScientiaCME to ensure that the COI is resolved in order to ensure the integrity of the CME activity. For this CME activity, any COI has been resolved through content review ScientiaCME.
Faculty Disclosure: William T. McGee, MD, discloses that he receives honoraria and expense reimbursement from Edwards Lifesciences.
Disclosures of Educational Planners: Steven Sachse is an officer and part owner of ScientiaCME, LLC, which has received a grant from the commercial supporter of this program: Edwards Lifesciences.
Commercial Support Disclosure: This program is supported by an educational grant from Edwards Lifesciences, a manufacturer of medical devices.
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